Open Recommendations

[Description omitted; DOJ has determined that this recommendation contains information that is limited official use or classified.]

[Description omitted; DOJ has determined that this recommendation contains information that is limited official use or classified.]

Ensure that Pathfinders develops and implements written policies and procedures on the reporting of PMT data, and has taken appropriate action to ensure its data system is capable of populating accurate reporting information.

Ensure that Pathfinders develops and implements comprehensive written financial policies and procedures that detail its fiscal activities and ensure compliance with the DOJ Grants Financial Guide and federal award requirements. These policies and procedures should include guidance on the appropriate allocation of costs to applicable funding sources.

Remedy the $1,800 in unsupported yoga consultant costs charged to the subawards through January 2024, as well as identify and remedy any additional unsupported yoga consultant costs charged to the subawards after January 2024.

Develop and implement guidance for DOT Operating Administrations and OST that addresses methods for estimating workforce needs-including appropriate data sources and methods for estimating workforce demand and the frequency or triggers for updating their estimates-and standards for documenting these planning procedures.

Revise departmental Infrastructure Investment and Jobs Act (IIJA) hiring reports to include the current number of onboard IIJA employees in addition to reports on IIJA hiring selections.

The Lieutenant Colonel Charles S. Kettles VA Medical Center Director ensures that service chiefs responsible for required invasive procedure infrastructure services ensure the completion of the annual review of infrastructure and that existing infrastructure is accurately reported.

The VA Healthcare System Serving Ohio, Indiana, and Michigan Network Director reviews the process for tracking invasive procedure complexity infrastructure waiver requests, and takes actions as needed to avoid delays in review and submission.

The Under Secretary for Health ensures that guidance provided to Veterans Integrated Service Network and facility leaders regarding the invasive procedure complexity infrastructure waiver request process is clear and consistent with Veterans Health Administration Directive 1220(1).

The Lieutenant Colonel Charles S. Kettles VA Medical Center Director confirms that acute and emergent patient transfer times related to waived infrastructure requirements are tracked and monitored, identifies trends or adverse patient outcomes, and takes actions as warranted.

The Lieutenant Colonel Charles S. Kettles VA Medical Center Director directs the chief of surgery, or designee, to attend blood utilization review committee meetings per facility requirements, and ensures compliance.

The Under Secretary for Health reviews Veterans Health Administration Directive 1400.01 to confirm that the supervision of PGY-1 surgery residents and guidance provided to Veterans Health Administration facilities aligns with Veterans Health Administration policy and Accreditation Council for Graduate Medical Education program requirements.

The Lieutenant Colonel Charles S. Kettles VA Medical Center Director ensures that operative documentation is completed per facility policy, reviews the methodology for monitoring operative documentation compliance, and takes action as necessary.

The Lieutenant Colonel Charles S. Kettles VA Medical Center Director reviews and monitors staff and health professional trainee compliance with the rules of behavior as it applies to authorized access to all VA computer programs including clinical applications.

The Under Secretary for Health evaluates the process for granting authorized access to VA computer systems for health profession trainees and takes steps to ensure access is provided by the start of trainee rotations at VA facilities.

The VA Healthcare System Serving Ohio, Indiana, and Michigan Network Director ensures the corrective actions developed by facility leaders to address surgical intensive care unit patient safety concerns are completed and evaluated for effectiveness.

Resolve the $388,319 in questioned salary costs and direct Columbia to repay or otherwise remove the sustained questioned costs from its NSF awards.

Direct Columbia to provide documentation supporting it has repaid or otherwise credited the $48,706 in questioned unsupported subaward and relocation expenses for which it has agreed to reimburse NSF.

Direct Columbia to strengthen its policies, procedures, and internal controls around subrecipient monitoring to ensure subawardees comply with federal and NSF requirements when incurring expenses under NSF awards. This could include implementing additional procedures that require Columbia to verify that subawardees maintain adequate documentation to support expenses and submit invoices based on actual expenses incurred and not based on the award budget.

Direct Columbia to implement additional procedures that require it—or its subawardees—to perform periodic reconciliations to ensure that expenses paid to its subawardees are supported by the subawardees’ financial records.

Direct Columbia to develop additional resources that provide guidance to subawardees on the types of documentation they are required to retain in order to support the allowability of salary and relocation expenses charged to NSF awards. These resources should also address ensuring fringe benefit rates are not applied to non-salary expenses.

Resolve the $200,726 in questioned costs and direct Columbia to repay or otherwise remove the sustained questioned costs from its NSF awards.

Direct Columbia to provide documentation supporting it has repaid or otherwise credited the $14,161 in questioned unallowable fringe benefit, subaward, and travel expenses for which it has agreed to reimburse NSF.

Direct Columbia to strengthen its policies, procedures, and internal controls around subrecipient monitoring to ensure subawardees comply with federal and NSF requirements when incurring expenses under NSF awards. This could include developing additional resources for subawardees that provide guidance regarding the allowable charging of expenses—including salary, bonus, fringe benefit, visa, and travel expenses—consistent with federal and NSF regulations.